Talk:Codeine

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[edit] Expansion please - History, Financial and Statistical information

A little history on the who, when, how, and why the drug was discovered or created, and its use came to be would be a welcome addition to this article. Carlossuarez46 19:30, 17 July 2007 (UTC)

I agree, and have added history to this title. I have also moved this to the top for more attention. Although codeine has always been in raw opium, information needed are History about:
  • the discovery of codeine presence in opium
  • the discovery of converting morphine into codeine (who, where)
  • the extraction process of native codeine from raw opium
Also some financial data would be nice:
  • codeine sales
  • statistics on codeine usage over other pain killing medicines
Aswell as:
  • usage in modern entertainment and the fact that there is a music group who calls themselves "codeine" after the drug.
If anyone else has anything to add, please feel free to edit the above. Once the relevant information is added, either remove the bullet point or add "check" or "done" in italic next to the bullet point. --87.194.3.52 18:04, 12 August 2007 (UTC)



[edit] Canada

"In Australia and Canada, codeine is regulated, however it is available without prescription in combination preparations from licensed pharmacists in doses up to 12.5 mg/table"

Health Canada regulations allow for codeine in combination with at least 2 other medicinal ingredients to a maximum of 8mg per tablet or per 5ml available without a presciption in the pharmacist access area (Tylenol #1, 222's, combination cough liquids, Robaxacet with codeine are examples)208.38.3.162 14:24, 8 June 2007 (UTC)

I am looking for the source of this information. I have heard many times that codeine is available without a prescription in Canada, but can not locate any references to reputable websites, such as Health Canada.

In Australia Codeine is available up to 15mg per tablet without presecription. I have updated the article.

Mystic eye 16:23, 19 December 2005 (UTC)

Also: I would like to point out that codeine is available without prescription in the UK coupled with ibuprofen in 12.8mg/tablet doses. Perhaps the article should be modified slightly to reflect this? 82.4.43.239 00:06, 9 March 2006 (UTC)

I live in Canada, and the most I can buy 8mg codeine/325mg paracetemol/15mg caffeine Over the counter. Next time I go to buy some, Ill ask if they have higher amounts of codeine, but I doubt you can get it without a prescription.Peoplez1k 02:30, 19 May 2007 (UTC)

I'm in Ireland, sopadeine is available in pharmacies over the counter. There's a UK site for it.

Just go to any Canadian pharmacy and ask for generic Tylenol 1: 8mg codiene/300mg acetaminophen/15mg caffeine. The "reference" here is personal experience (Alberta in particular, but I'm sure its true anywhere) Sometimes you have to sign something, sometimes they ask no questions at all. —Preceding unsigned comment added by 68.150.52.70 (talk) 12:44, August 26, 2007 (UTC)

[edit] Lean

I do believe that codeine is what is used in the drink "Lean". Its an alcoholic drink most common amongst youth in Texas. Some mention should be made to that.--Jaysscholar 05:22, 23 September 2005 (UTC)

That is true to an extent. Lean is actually just the nickname of the codeine syrup that kids drink. They make mix it with drinks or coat blunts with it.

Codeine is mixed with soda such as sprite,not alcohol, to create "lean". Made popular by early pioneers of screwed music like DJ screw, Big Moe Fat Pat and LIl' Flip; they were the ones to bring codeine to the drug culture as lean. (unsigned)

This had been in the article before, and then removed, presumably for lack of verifiability. However, the reference links in Purple drank seem to check out, so I'm going to put a brief mention of this back into the article. - Pacula 16:39, 27 September 2007 (UTC)

[edit] Paracetmaol helping with withdrawals

A heroin addict may use paracetamol to ward off the effects of a withdrawal

Methadone and perhaps codeine (both opioids) may be used to ease withdrawal - but paracetamol is a different type of analgesic and I have never heard of it being used in this way.

I was addicted to Methadone for 6 months and paracetamol has no effect what so ever on withdrawls. Paracetamol contains no opiates thus has no effect on the opoid receptors craving opiates. The opiate withdrawls, being very similar to the flu (fever, cold sweets, discomfort, nausea, etc.), one would think since those are some of the uses for paracetamol that they would theoreticly work; but the causes of symptoms are manifested for completely different reasons.

Paracetamol has no reversible effects on the withdrawal symptoms, but DOES help with withdrawal symptoms. Paracetamol lowers the body temperature (anti-pyretic) and also helps with very mild pain. Since withdrawal symptoms can include fluctuations in body temperature and also pain, it can easily be argued that paracetamol might help with withdrawal symptoms. But whether it can reverse the withdrawal symptoms, No, since it is not an opioid. It's a tricky sentence, but whoever wrote it was theoretically right, but wrong in practice. --87.194.3.52 16:39, 12 August 2007 (UTC)

CAN ANYONE FIND A SOURCE FOR THE SENTENCE ABOUT GETTING CODEINE IN NEW JERSEY WITHOUT A PRESCRIPTION? —The preceding unsigned comment was added by 63.145.150.3 (talk • contribs) .


I agree with the above concerning Paracetamol, I also was addicted to morphine, heroin and pentazocine, paracetamol is of no use for withdrawals

Not sure where this would fit in, but when I was really young I had quite unpleasant hallucinations associated with the withdrawal. (Thank heavens I can't remember any of it.) Is that already in the article? I couldn't find it. 71.213.127.231 22:53, 17 October 2007 (UTC)

[edit] "it's an OPIATE not an OPIOID. Opioids are synthetic, codeine is not synthetic"

This is an editor's quotation. However according to the Wikipedia articles opioid and opiate, codeine is an opiate because it derives from opium and an opioid because it binds to the opioid receptors. Do you mean that those Wikipedia articles are incorrect? --Jclerman 20:17, 10 August 2006 (UTC)

Codeine can be classified as either an "opioid" (a drug that binds to opioid receptors) or an "opiate" (opioid drug derived from opium). That particular editor is incorrect in saying that "opioids are synthetic" – the other articles are correct. -Techelf 10:11, 12 August 2006 (UTC)

[edit] Date of synthesization?

Does anyone know what year Codeine was first synthesized from Morphine? I was unable to find it on the DEA's Drug Information page. 19:27, August 15, 2006 BigSciZot

The same day morphine was synthesized into codeine. The procedure is reversible in the knowledge of any chemist. --87.194.3.52 16:35, 12 August 2007 (UTC)

[edit] French Article

The article regarding codeine use in France says that codeine is not a euphoriant; it also claims 95% of the syrups use in not medicinal. Is the author credible?

[edit] UK Limits for OTC medicines

The law concerning the maximum allowable amount of codeine allowed in non-prescription medicines can be found in section 2.1 of this document on the Medicines and Healthcare products Regulatory Agency.

The strongest codeine-containing medicines available without a prescription contain 25.6mg of codeine per maximum single dose, ie Solpadeine Max (500mg Paracetamol/12.8mg Codeine per tablet, recommended dose 1-2 tablets) and Nurofen Plus (200mg Ibuprofen/12.8mg Codeine per tablet, recommended dose 1-2 tablets).80.229.137.187 20:56, 7 October 2006 (UTC)

That is somewhat wrong. According to the above statement, a single pill containing 25.6mg of codeine should be legal if marketed as "maximum single dose" but would have far more abuse potential than 2x 12.8mg containing tables. The general rule here is per 12.8mg of codeine there needs to be 500mg paracetamol or 200mg ibuprofen. In other words, per maximum single dose the requirements are 25.6mg of codeine with either 1g paracetamol or 400mg ibuprofen with a maximum of 12.8mg per pill. --87.194.3.52 02:00, 12 August 2007 (UTC)

[edit] Link on extracting codine from tablets

Is this really necessary? It seems to me that it doesn't contribute anything to the article, and it seems quite unencyclopedic 203.5.70.1 11:08, 5 November 2006 (UTC)

Is also really stupid dumb ass!!!

Well, at the least people will not damage their livers with the paracetamol.

See the discussion page for cold water extraction for the justification of why it is here. It's encyclopedic, and is a standard procedure in chemistry. Tmrussell 10:30, 29 April 2007 (UTC)

It not totally correct either. Hot water extraction would remove the paracetamol, not the codeine as is implied.

Bobby charriot 23:52, 5 January 2007 (UTC)

Is cold water extraction , not hot. And is paracetamol that damages the liver (can cause death) , not the codeine

[edit] Is Codeine/Tylenol 3 also an anti-inflamatory?

I have been perscribed Tylenol 3 for the occasional pains that occur as a result of an ongoing health problem, for use on an as-needed basis. For some time now I have not needed to take it, but I still keep it on-hand.

Last night, after nearly a month of an aching right leg, I took one tablet under the advice of my health nurse so that I would sleep better. The Tylenol 3 did indeed help the pain (as well as making me sleepy enough to spend all day in bed), and now almost 24 hours later, the pain is still very mild. Could the Tylenol 3 have had an anti-inflamatory effect and "cured" the problem with my leg? CG janitor 07:36, 21 December 2006 (UTC)

Tylenol is indeed an NSAID (anti-inflammatory). I don't think codeine has much effect on that. This isn't really an appropriate conversation for a wikipedia talk page though! Go ask a doctor, or talk to your nurse some more. Gigs 00:07, 3 January 2007 (UTC)
Actually, neither codeine nor acetaminophen is considered an anti-inflammatory. To quote the paracetamol (AKA acetaminophen) article, "Paracetamol, unlike other common analgesics such as aspirin and ibuprofen, has very little anti-inflammatory properties, and so it is not a member of the class of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs)." --Galaxiaad 00:05, 4 January 2007 (UTC)
Galaxiaad is partly correct. Actually, acetaminophen has NO direct anti-inflammatory properties, so maybe someone should correct the other cited article. --87.194.3.52 16:25, 12 August 2007 (UTC)

[edit] Recreational use - Ilicit synthesis of morphine from codeine

The method described in the article of synthesising morphine via demethylation of codeine with pyridine is incorrect. In fact what should be used is pyridinium hydrochloride.

In the hands of an inexperienced chemist, the resulting product would likely be heavily contaminated with pyridine, resulting in a foul smell which would likely deter even a hardened addict from using it. There are much easier and cheaper ways to obtain morphine than this.

Should this be deleted from the article? The section is about recreational use, not ilicit drug synthesis.

Bobby charriot 23:46, 5 January 2007 (UTC)

Absolutely this should NOT be deleted from the article. The article should just tell the truth, which is that an amateur chemists can convert codeine to morphine, but are complete idiots to do so because of the toxic (and possibly carcinogenic) by-products. The public needs to know that there are silly people doing this. Tmrussell 10:30, 29 April 2007 (UTC)
No, leave the morphine synthesis in the article. Tmrussell, there are no cited information or reports as far as I know about anyone in the public synthesizing codeine into morphine except 1 case many years ago in New Zealand. It is inefficient, highly undesirable and uncommon to synthesize morphine from codeine using pyridine. The only reason this was included in the article is to tell the public it is Possible to synthesize codeine into morphine, but that is a very uncommon practice. It is far more cheaper and easier to buy illicit heroin than the procedure required to synthesize morphine from codeine. --87.194.3.52 16:29, 12 August 2007 (UTC)

[edit] Are they suggesting over 60mg of codeine at once has no use ?

there is a line there saying: "Theoretically, a dose of approximately 200 mg (oral) of codeine must be administered to give equivalent analgesia to 30 mg (oral) of morphine (Rossi, 2004). It is not used, however, in single doses of greater than 60mg (and no more than 240 mg in 24 hours) since there is a ceiling effect."

Isn.t it used in doses greater than 60mg at once?! It seems absurd. And why ? It has no extra effect ? The people using it reacreationally in average doses of 150-300 claim the contrary. Puzzled.

It IS essentially accurate to state that 60 mg is the correct dosage. 1. up to 60 mg there is a feeling of well-being, anxiolytic effect and lessening of pain. These are appropriate medical objectives. Higher than 60mg produces euphoria. Euphoria is not a valid medical objective, and going higher than 60mg goes against the medical principle which is to always use the minimum amount of the drug required to achieve the required objective. 2. The only way a person could need more than 60mg just to get a lessening of pain would be if they had a developed a tolerance to opiates due to over-usage. Once again, this is undesirable. Conclusion: infrequent usage of up to 60mg of codeine is medically justified. I hope this helps answer your question. Tmrussell 10:30, 29 April 2007 (UTC)
I think that's awfully reductive. First, I don't think "a feeling of well-being" and "anxiolytic effect" are ever aims, at least stated, for therapeutic use of opioids. Second, it's not like once you cross 60 mg you're suddenly in euphoria territory. What is the difference between "a feeling of well-being" and "euphoria" anyway? I think the main reason that codeine is not used in amounts greater than 60 mg is that the usual practice is to change to a stronger opioid when greater analgesia is required (or when the patient has a tolerance, as in chronic pain). If 30 mg of morphine gives equivalent analgesia to 200 mg of codeine, it can be assumed that it also gives equivalent euphoria, etc. (because both effects are mediated by CNS opioid receptors). Yet this dosage of morphine is used therapeutically. Finally, the ceiling effect bit in the article is misleading; the ceiling dose isn't till around 200-400 mg. I'm going to clarify it. --Galaxiaad 16:33, 29 April 2007 (UTC)
Your response to my post, Galaxiaad, is pretty good, and leads me to think about qualifying some of my statements. I don't think there is always such a clear-cut distinction between "pain reduction" and "feeling of well-being". If we neutralise the discomfort with an opioid, that to me is converting discomfort into a "feeling of well-being". If we (unwisely) go further than the amount required to do that, then I define that as producing "euphoria". Also, consider that they might have something like a cold, and there might not be any highly localisable physical pain, but rather just a general feeling of being unwell and fatigued. If we can get rid of that feeling of unwellness then the patient can get higher quality rest and actually get better faster. I conclude that producing "a feeling of well-being" is a valid medical objective, though some would rather put it differently. As for the "anxiolytic effect", well I must admit this is contentious. In psychiatry, the treatment of serious anxiety disorders is fraught. As well as anti-depressants and anti-psychotics, we prescribe Benzodiazepines. In Australia, we have a serious problem with over-use of Benzodiazepines, so some practicioners are willing to countenance infrequent use of codeine as an anxiolytic as part of a multiple treatment regime, to reduce benzo-dependency. After all, some of these patients are in a really bad way and we are really at our wit's end in dealing with them. It is not at all controversial to say that opioids are anxiolytic, but you would be completely right to say that using codeine as an anxiolytic is not a standard regime. On the issue of "the 60mg limit" well I have to revise my opinion. You are quite right in saying that we use a stronger opioid when stronger analgesia is required. My statement is only correct given that for lesser-level pain ailments (such as having a cold), in which case the weaker analgesic (codeine) is indicated. Sorry I was wrong about that.Tmrussell 15:36, 2 May 2007 (UTC)

Even a 2mg dose is known to be habit inducing. Euphoria/Contentment that comes with codeine does not happen past a certain mark, but gradually intensifies with dosage until the nearing of the ceiling effect limit. Contentment/Euphoria comes with all opioid's and cannot be avoided, not even with Tramadol. All the effective painkillers with no longterm side effects (except habituation) are opioids. The feeling of well being or euphoria codeine produces is sometimes unnoticeable at first, especially at low doses and with patients who have not used codeine before. They begin to realize the emotional well-being effects of codeine when it lack presence after a period of use, followed by a "ah" fix when their dose it taken. This has nothing to do with the relieving of physical pain, but the codeine's effect on the opioid receptors in proxy on the dopamine system. 200-400 mg is an estimate and very inaccurate. If you want to know how much you can take before reaching the ceiling effect then read on which I hope will partly answer your question. Euphoria does intensify with increasing the dosage and drifts off nearing 75%-90% of the ceiling effect. Analgesic properties likewise. The ceiling effect is per dose and not over the 24 hours, however once the ceiling effect is met, any further codeine will have no effect until the previously given dose is fully processed (2-8 hours, sometimes longer). The real ceiling effect can be calculated by using the rule that 7mg of codeine per 1 kilo of bodyweight is the ceiling effect. So a 75kg male would be able to consume (7x75=525mg) with effective analgesia and euphoria at 75%, meaning a single dose 393mg will be near all efficient (this is not always the case, read on). Anything above 525mg will have no or little effect. Even that rule of thumb can be argued as every individual is different, and we see many people with unusually high CYP2D6 enzyme presence who can process more codeine and some with little CYP2D6. (CYP3A4, UGT2B7 also have part to play on this ceiling effect as also mentioned in this article). How long codeine is used, liver condition, and gender also play a part as well as age on the ceiling effect. Alcohol and usage of other medicines that put a burden on the liver can also affect the ceiling effect of codeine. But generally 7mg per 1kilo is the rule of thumb many of us GP's were taught, however when greater deal of pain management is required we normally prescribe stronger pain killers other than codeine. Simply because stronger opioids are more consistent, do not have a ceiling effect in case the dosage needs to be increased and more flexible. Please do not ask where this information on the 1:7mg is from as it was something we learned in Med school. If your bothered, have a look online i'm sure you will find a source so this can be added to the article. By the way, the weight generally takes into consideration the BMI, in other words a obese person would probably be no more able to process codeine than if he was his normal bodyweight. However, this is the theory, and in practice, everyones liver differs, some can take more some less, and please do not try to max out your dose, if you seriously want to enjoy the euphoria codeine brings as well as the pain killing effects, maintain a dose which works for you and do not increase as tolerance might develop. Enjoy, but responsibly. Bye. --87.194.3.52 02:11, 12 August 2007 (UTC)

- Where on earth or you people getting this idea that enzyme saturation means that there is an upper limit to the amount of codeine that can further produce any effect? If an enzyme is saturated, that simply means that increasing the concentration of substrate cannot increase the rate of reaction any further. It does not mean that the reaction stops taking place. So, enzyme saturation does not mean that the reaction cannot proceed any further: it simply means that the reaction cannot proceed any faster. I would like to see at least ONE reasonable reference for the claim regarding ceiling codeine doses and I would also like a reasonable explanation as to how enzyme saturation implies a ceiling dose. I would also like to see experimental evidence of this. This claim about the ceiling dose is just silly. Think of it this way, if a given dose of codeine saturates CYP2D6 so that the enzyme turns codeine to morphine at its upper limit, all this means is that any further codeine beyond that dose just has to wait its turn in order to be converted to morphine. It does not mean that the reaction proceeds no further. For all of the nonscientist out there, here is an analogy. An enzyme is like a machine that turns raw goods (S) into a finished product(P). Each machine can operate at some given maximum speed (say, 5 volumes of S can be converted to P per hour). A saturated machine is one that is operating at full capacity. That is to say, that piling up more raw goods around the machine will not make the machine operate any faster. Even if you pile up a thousand days worth of raw goods around one machine (ie. the machine is totally saturated), that doesn't mean that the machine can only produce a finite amount of raw goods. It just means that the machine can only produce so many raw goods per amount of time. Similarly, with an enzyme saturated by ligand, any excess ligand will simply have to wait its turn to be converted to product. Now, sure, there will be a ceiling effect due to competing processes that eliminate the substrate in other ways, but nobody has provided any evidence whatsoever for this seemingly arbitrary 400 mg ceiling dose. Please provide evidence for this ceiling dose claim. —Preceding unsigned comment added by 216.99.61.220 (talk) 06:42, 14 December 2007 (UTC)

[edit] The section describing recreational dose is completely bogus

While I can't speak to the actual recreational and therapeutic dose ranges, the ranges listed here seem high. Consult the Physicians Desk Reference or "PDR" for the legit answer on therapeutic range. Anyone who has ever taken codiene can tell you that the therapeutic doses certainly have a recreational aspect to them, so the idea that you have to take so much more to get into the "fun" range is just logically false.

Most innaccurate, however, is the idea that the effects of the drug are limited by your liver's ability to metabolize it. The liver breaks things down. Therefore, a higher capacity for metabolization would mean less effect, not more. These is one of the most glaring errors I have ever seen on Wikipedia. This is why people without scientific backgrounds cannot be allowed to write this type of article. There are tons of "experts" out there on recreational drugs that espose nothing more than myths - whoever wrote this is one of them. Also, as for the opiate/opioid debate, both are acceptable. —The preceding unsigned comment was added by Soszai (talk • contribs) 21:50, 31 January 2007 (UTC).

I don't claim any special knowledge of the subject matter of the article, but reading it verified the obvious inference that the liver metabolises codeine to its active form. This indicates, rather poetically, that the comments above seem to apply well to the author of the comments. Elroch 10:39, 24 August 2007 (UTC)

Codeine containing products will typically contain 8-60mg per unit. While an opiate naive person may find a therapuetic dose (~60mg) somewhat euphoric, a person with tolerance or experience with other opiates will likely choose a dose in the range listed for recreational use. Usually codeine use is limited by the fact that at around 400mg (for most people) a ceiling effect is reached due to saturation of CYP2D6. Beyond this area there will be little (if any) therapeutic or recreational value, while the side effects will increase to an unacceptable degree. The article is accurate. My phantom limb 12:11, 26 March 2007 (UTC)

Physicians Desk Reference only guides the GP on how much to prescribe for pain, not for the euphoria. Although codeine can have effective analgesia up to 90% of the ceiling effect, it is generally accepted that if a patient requires that much for pain control, it is better to switch to a stronger pain killer. Yes you are right, even 2mg dose of codeine can induce a liking in the user, but very subtly. Many codeine users we see are "addicted", notice the speech marks, to ridiculously low amounts which generally should only bring 1-2 days of very very mild discomfort upon cessation. However, most recreational users take larger amounts of codeine simply because the euphoria intensifies. Yes therapeutic doses do induce euphoria, above 15mg I would say noticeable, but above therapeutic doses also carry a stronger more intense euphoria hence most recreational users tending to pass the therapeutic standards. The euphoric values generally increase until they slop off nearing the ceiling effect. In a frequent recreational codeine user with some tolerance, little doses such as 30-60mg will generally have little effect, although noticeable. However, since a recreational user is one that tends to dabble with codeine, tolerance is generally not present although mentally they could have made a familiarity with the low dose euphoria being left tempted to intensify the effects. I wrote this in the above discussion and it might be relevant to your question:
200-400 mg is an estimate and very inaccurate. If you want to know how much you can take before reaching the ceiling effect then read on which I hope will partly answer your question. Euphoria does intensify with increasing the dosage and drifts off nearing 75%-90% of the ceiling effect. Analgesic properties likewise. The ceiling effect is per dose and not over the 24 hours, however once the ceiling effect is met, any further codeine will have no effect until the previously given dose is fully processed by the liver (2-8 hours) (also note, subsequent codeine doses in the same day might have less euphoric properties, not because of the ceiling effect, but due to minimal tolerance). The real ceiling effect can be calculated by using the rule that 7mg of codeine per 1 kilo of bodyweight is the ceiling effect. So a 75kg male would be able to consume (7x75=525mg) with effective analgesia and euphoria at 75%, meaning a single dose 393mg will be near all efficient (this is not always the case, read on). Anything above 525mg will have no or little effect. Even that rule of thumb can be argued as every individual is different, and we see many people with unusually high CYP2D6 enzyme presence who can process more codeine and some with little CYP2D6. (CYP3A4, UGT2B7 also have part to play on this ceiling effect as also mentioned in this article). How long codeine is used, liver condition, and gender also play a part as well as age on the ceiling effect. Alcohol and usage of other medicines that put a burden on the liver can also affect the ceiling effect of codeine. But generally 7mg per 1kilo is the rule of thumb many of us GP's were taught, however when greater deal of pain management is required we normally prescribe stronger pain killers other than codeine. Please do not ask where this information is from as it was something we learned in Med school. If your bothered, have a look online i'm sure you will find a source so this can be added to the article. By the way, the weight generally takes into consideration the BMI, in other words a obese person would probably be no more able to process codeine than if he was his normal bodyweight. However, this is the theory, and in practice, everyones liver differs, some can take more some less, and please do not try to max out your dose, if you seriously want to enjoy the euphoria codeine brings as well as the pain killing effects, maintain a dose which works for you and do not increase as tolerance might develop. And as a personal note, codeine is a fairly safe opioid since the euphoric effects tend to be fairly unaffected by increased or prolonged use in most cases if the dose is maintained. Enjoy, but responsibly. Bye. --87.194.3.52 02:11, 12 August 2007 (UTC)

The statement that the quicker the liver metabolizes codiene, the less the effect is incorrect. This article is ablsolutely correct, as codiene is inactive until it is processed to morphine by the liver. Codiene itself has no therapeutic value, it MUST be metabolized. I thought the article already made that clear. There is also great variability in CYP2D6 function, which means there is great variability in peoples response to codeine. Some people can take 30mg, and get noticeable euphoria, and pain relief, and others might not get noticeable euphoria until 150-200. I have personally taken 400mg codeine (but had tolerance) with no ill effect, and if I am intolerant I don't notice euphoria or pain relief in doses below 150mg. I am pretty sure my CYP2D6 function is slower than average, as it also takes about 1 hour before I even notice any effects. So yes, although I am going against my doctors instructions, codeine is very much effective in doses greater than 60mg, but a doctor will not recommend this. People with mild or moderate pain don't need stronger pain killers anyway, the possible risks outweigh the benefits, and doctors won't give you morphine or Percocet just because you say 60mg codeine isn't working well enough, unless there is severe pain, and medical reason to do so. I am also assuming that the user is using codeine recreationally from prescription products. If the cold water extraction is used from a 300mg acet/15mg caff/8mg codiene tablets, then there is also the fact that 200mg of codiene extracted contains 375 mg caffeine as well (3 expressos). This alters the way the drug is subjectively felt, with that amount of caffeine entering the bloodstream (unless you are totally a caffeine addict). So yes... some people will require larger doses to get euphoric effects, some will get euphoric effects at prescribed doses, its just that no doctor will recommend that you take 200-300mg of codeine at once for any reason (even though you probably could take that much without damaging your body, you are just "over medicating" yourself). —Preceding unsigned comment added by 143.166.255.57 (talk) 23:25, 5 September 2007 (UTC)

I think the previous statement was talking about people with no tolerance. And by recreational he/she meant "someone that dabbles", not a daily user. --78.86.117.164 15:25, 22 September 2007 (UTC)

[edit] "didehydro" - unknown prefix

Please change "didehydro" in "dihydro" in the offered IUPAC name. Only "dihydro" makes sense. Thanks.

The name refers to di-dehydro, which is something different than dihydro. The name stated in the drugbox ("(5(,6()-7,8-didehydro-4,5-epoxy-3-methoxy-17-methylmorphinan-6-ol") is correct, see e.g. the drugbox entry (here). Hope this helps. --Dirk Beetstra T C 18:24, 4 March 2007 (UTC)

[edit] Australia has 15 mg over the counter

You can get panadeine 15 (500mg of paracetamol and 15 mg of codine) over the counter at a pharmacy.

Nurofen Plus is 13.8 mg...

Don't know if I am allowed to update the article.

As far as I have ever seen in Australia, OTC tablets come in 10mg and 8 mg codeine (with 500mg paracetamol). Nurofen Plus is 12.8 mg codeine (with 200mg ibuprofen). If anyone thinks that this is incorrect, please post below here. Otherwise I will be editing the page in about a week. Come to think of it, also post if you think my figures are correct. Of course I could be wrong, seeing as I am just going on what I have seen.Tmrussell 05:50, 25 April 2007 (UTC)

you CAN get panadeine 15 (15mg codeine) OTC in australia

however codeine linctus CANNOT be brought OTC. it isn't even S4 anymore, its S8, like morphine. rikodeine can be bought OTC but this is different.

thanks for the information about Panadeine-15 Lucky I posted here before editing the main page. Tmrussell 08:07, 13 May 2007 (UTC)

[edit] India has unaccountable rate of OTC misuse

Recreational Use or State of Euphoria are terms which I find are misleading.The proper term would be the use of Codeine based (phospahtes/sulphates dissolved with chlorophenaramine maleate and acetominophenes)for the alteration in the brain's ability to perceive the surrounding environment.I do not if I am allowed to disclose the "Brand Names"of the 2 leading pharma companies whose products are among the highest misused drugs otc.However some states like Punjab,Most of the N.E. region states and New Delhi do not sell these cough syrups without a prescription ;but still its usage stands at 75% of the most common mind altering drugs in liquid form second only to alcohal among the youth age group of late teens-35 years.
In the year 1992-94;the use of codeine based syrups reached an all time high.At that time ;the codeine based cough syrups also had among its contents :Ephedrine and Phenargan's base;which was the (IMHO though I'm not sure)trigger activating the feeling of an overflow of adrenaline and heightened sense of visuals and aural elements ;almost like the ones describes by Huxley in his book "The Doors Of Perception".Since it (still)is OTC drug along with cheap cost;and ignorance of populace about it led it to being the most sold/bought cough syrups by youngsters.Although in late 1997-99 the manufacturers to withdraw all stocks from the shelf and then released altered formula base containing only "Codeine with Chlorophenaramine Maleate and SunsetYellow with flavoured base.However ,it was still used in the same way by external intake of tablets of ephidrine HCL 10mg and Phenargan and Spasmoproxywan capsules.Of course ;hot filtering. Side effects: Dryness,loss of natural moisture like tear in eyes,lips,swollen tongue,bitterness and loss of taste,tightenign of jaws,problems in speaking fluently,constricted pupil,delusion,paranoid and self pity.--asydwaters 14:30, 12 April 2007 (UTC)

Does a tobacco user abuse/misuse tobacco? Does a marijuana smoker abuse/misuse marijuana? Does a coffee user abuse/misuse coffee? Does a drinker abuse/misuse alcohol?? Codeine is a euphoria inducing drug, if the use of codeine recreationally is "misuse", then many other substances we use daily to relax/feel better can also bear the term "misuse". If codeine could not alleviate pain, but still had euphoric properties, i bet any money the term misuse would be used farless. Also remember, OPIUM (containing codeine) was used as a recreational drug many years before it was used medicinally, giving the recreational use a far more natural human behavior than that of medicinal use. --87.194.3.52 16:45, 12 August 2007 (UTC)

[edit] New pics from DOJ

Pictures taken from the Department of Justice's website.USDOJ Fuzzform 03:24, 3 May 2007 (UTC)

These might perhaps belong on co-codamol or similar. Fuzzform 03:26, 3 May 2007 (UTC)

Oddly, the ones on the far right (Tylenol 2-4) are mixed up. Tylenol 3 has 30 mg codeine and Tylenol 4 60. --Galaxiaad 03:08, 23 July 2007 (UTC)

[edit] Codeine/Venlafaxine contraindication claim

I've marked a {{Fact}} tag on this claim in the article as I can find no relevant info to back it up, and I myself am on venlafaxine and have no issues with codeine. Timeshift 07:55, 19 May 2007 (UTC)

Its not a contraindication (as far as I know, but i'm not a doctor), it is metabolized by the same enzymes. What this means is your venlafaxine may be using up some of the enzymes, causing decreased codeine effect (as this interferes with its conversion to morphine). However, if your CYP2D6 function is normal, then you should have no problem taking a normal prescribed dose of venlafaxine, and a normal prescribed dose of codeine. You may notice stronger codeine effect if you were to stop taking your venlafaxine for a couple days, that's all. —Preceding unsigned comment added by 143.166.255.41 (talk) 02:18, 9 September 2007 (UTC)

Yup. Fluoxetine and paroxetine are also metabolized by that enzyme (see CYP2D6 for a longer list). I've taken a significant amount of codeine to no effect while on fluoxetine. --Galaxiaad 02:40, 9 September 2007 (UTC)

[edit] Diarrhea vs Diarrhoea

The on going battle of US English vs British English. The problem in this case is the article name is Diarrhea - [Diarrhoea] is a redirect page to Diarrhea. Dbiel (Talk) 00:47, 3 July 2007 (UTC)

The spelling seems to keep getting reverted. We should acknowledge the differences in spelling but the link itself should be to the actual page name it links to rather than to the alternate spelling that is a redirect page. Dbiel (Talk) 03:08, 23 July 2007 (UTC)

Since the origins of Wikipedia is in the US, and the encyclopaedia's English section first took popularity in the US, it is accepted to use US English over British English. --87.194.3.52 16:50, 12 August 2007 (UTC)


[edit] Original Research

The amount of original research and unverified (or sourced) claims must be heavily edited from the recreational use section. If a statement cannot be backed up with verifiable and valid source then it does not belong in an encyclopedia, especially statements like this: " In Texas, codeine in syrup form is called Lean. It is commonly mixed with a soft drink such as Sprite (to make a drink called purple drank)."

Information like that adds nothing to the article, and unless there are valid and verifiable sources to backup the statement it must be truncated entirely. Nja247 (talk • contribs) 21:41, 24 July 2007 (UTC)

A simple statement stating that the recreational use of codeine does exist, and a little description is enough. --87.194.3.52 16:46, 12 August 2007 (UTC)


Are you sure the phrase "truncated entirely" is the one you are looking for? —Preceding unsigned comment added by 154.5.12.245 (talk) 17:19, 15 November 2007 (UTC)

[edit] cannot be attributed to non-medical use?

In the recreational use section it says: It is reported that in France, 95% of the consumption of Néo-codion cough preparation, containing codeine, cannot be attributed to non-medical use.

To me this implies that 95% is not recreational, and therefore only 5% is recreational. Is this really what is meant? If it is, then it could be worded in a less round-about way.

Because of the weasel words it is reported that...', I'd also like to see a citation for that 95% figure, whatever it claims to represent. Royhills 20:55, 4 August 2007 (UTC)

I believe it was a mistake. I changed it to "can be attributed to non-medical use". There is a reference for that figure, an article in French (ref 10). --Galaxiaad 21:35, 4 August 2007 (UTC)
Galaxiaad, thanks, I checked the source. --87.194.3.52 16:47, 12 August 2007 (UTC)

[edit] Death

"Some people may also have an allergic reaction to codeine, which may cause severe illness or even death" is a strong statement, and there is no citation or source to verify the claim. I have rephrased the sentence until a citation is available, if at all in existence: "Some people may also have an allergic reaction to codeine, which may cause severe allergic reactions such as the swelling of skin and rashes." The swelling and rash is typical and documented in any codeine medicine leaflet and generally accepted as a allergic reaction or signs off exceeding the ceiling effect within the medical community. However, death by an allergic reaction is absurd unless mixtures of other drugs were used resulting in respiratory depression, high dose codeine in infants or overdose in opioid naive people. A fatal overdose is different than claiming deaths from allergic reactions, which has never occurred in the case of codeine from the research I have done.--87.194.3.52 17:07, 12 August 2007 (UTC)

[edit] Recreational Use

"people will frequently purchase it from multiple pharmacies so as not to incur suspicion" is generalizing that all people in some countries purchase it from multiple pharmacies. I have rephrased it so it only implies to people likely to recreationally use codeine, and not just "people". This also ties in with the source far more than the present phrase. It now reads "some potential recreational users are reported to buy the aforementioned from multiple pharmacies as to not incur any suspicion." --87.194.3.52 02:37, 12 August 2007 (UTC)

[edit] Expansion please - History, Financial and Statistical information

A little history on the who, when, how, and why the drug was discovered or created, and its use came to be would be a welcome addition to this article. Carlossuarez46 19:30, 17 July 2007 (UTC)

I agree, and have added history to this title. I have also moved this to the top for more attention. Although codeine has always been in raw opium, information needed are History about:
  • the discovery of codeine presence in opium
  • the discovery of converting morphine into codeine (who, where)
  • the extraction process of native codeine from raw opium
Also some financial data would be nice:
  • codeine sales
  • statistics on codeine usage over other pain killing medicines
Aswell as:
  • usage in modern entertainment and the fact that there is a music group who calls themselves "codeine" after the drug.
If anyone else has anything to add, please feel free to edit the above. Once the relevant information is added, either remove the bullet point or add "check" or "done" in italic next to the bullet point. --87.194.3.52 18:04, 12 August 2007 (UTC)

[edit] Funny brackets

Broken links because of funny brackets under Rec. use section, para 4. Deliberate? --81.105.243.17 (talk) 18:13, 10 February 2008 (UTC)

[edit] euphoria an adverse reaction?

Anyone find this a bit funny?

Common adverse drug reactions associated with the use of codeine include euphoria, …

Yes, it is a side-effect of normal medical treatment not exactly what I would call adverse :p 68.45.219.63 (talk) 19:53, 6 June 2008 (UTC)

Not everyone considers euphoria or getting high to be a positive thing, thus it's adverse since it's a reaction from the medicine which can adversely affect the user. Personal opinion doesn't really come into play here. Nja247 (talk • contribs) 10:09, 7 June 2008 (UTC)